Clinical Analysis Of 29 Cases Of Retroperitoneal Liposarcoma

ObjectiveTo investigate the clinical manifestations, pathological features, diagnosis, management and factors connected with prognosis of retroperitoneal liposarcoma.Methods29 retroperitoneal liposarcoma patients admitted to the second affiliated hospital of Zhejiang University School of Medicine between January 2010 and December 2015 were reviewed retrospectively and followed up. Pertinent literature were also reviewed. Data in this study was analyzed by SPSS 17.0 softwares. P<0.05 was considered to be statistically significant.ResultsThere were 29 patients in total, including 15 male and 14 female, with the mean age of 62.5±11.2 (range 34～83). Clinical manifestations included abdominal mass (79.3%), abdominal distention (55.2%), abdominal pain (17.2%), physical examination (10.3%) and lumbago (6.9%). All the patients received abdominal CT examination and 20 cases reported retroperitoneal liposarcoma (69%).20 patients received ultrasonography and 7 cases reported retroperitoneal liposarcoma (35.0%).7 patients received MRI examination and 5 cases reported retroperitoneal liposarcoma (71.4%). All the patients received surgery, from 1 time to 4 times,52 times in all.26 patients were followed up (89.7%). The median follow-up period was 22.5 months (range 0-66). Totally 19 patients recurred.15 patients recurred (57.7%) after surgery in our hospital and 11 cases died of retroperitoneal liposarcoma. The median survival time was 40 months,55 months for 21 patients with complete resection and 23 months for 5 petients with palliative resection, P=0.035.6 patients was still alive in 7 patients without recurrence and the median survival time was unpredictable while it was 37 months for recurrent patients, P=0.177. Univariate analysis revealed that methods of resection, hemorrhage during the operation, histological subtype and histological grade were important factors that influenced patients’ survival time. COX regression model multivariate analysis showed that hemorrhage during the operation and histological subtype were independent risk factors for patients’ survival time. Overall, the 1,3,5 year(s) survival rate was 82.6%(19/23),50%(8/16) and 25%(3/12) respectively since first surgery in our hospital.ConclusionsRetroperitoneal liposarcoma is a rare disease with atypical symptoms. CT is the most important examination to detect the tumor. Complete resection is the first choice for cure and combined organ resection is sometimes necessary. RPLS has a high rate of recurrence. Most recurrent patients can still be treated by surgery. Survival analysis reveales that methods of resection, hemorrhage during the operation, histological subtype and histological grade are important factors that influenced patients’survival time. To increase patients’ survival rate, adequate preperation is necessary to reduce hemorrhage during the operation and improve complete resection rate.